title: [An optimised assessment of "severely injured patients" for the documentation of road traffic accident black spots].
abstract: BACKGROUND
  The success of traffic safety improvement strategies is based on documentation. Analysis and remedy of accident black spots in addition to improvements in automobile production involve the work of traffic engineers, politicians, traffic regulations, police, and medical care. To create priorities, the traffic statistics differentiate accidents in a 3-class system in relation to severe accidents: slightly injured, severely injured and fatally injured (death). This study assesses the validity of the existing classification of "severely injured" compared with the actual injury severity.
  
  
  METHODS
  We analysed accidents resulting in 182 "severely injured" people in one year in a city model. A synchronisation of anonymous police documentation with the medical notes of admitted casualties which were validated by established trauma scores and medical classification was undertaken. A correlation analysis of length of stay should give indications of the actual injury severity.
  
  
  RESULTS
  The study group showed a ubiquitous range of age, sex and injuries despite a relatively low case number. The range of MAIS, ISS and NACA index scores shows the inhomogeneity of the people classified as "severely injured". 70 % of the study group revealed ISS < 16 which means that they are not polytraumatised patients. The correlation analysis according to Spearman certifies the validity of these scores (r MAIS/NACA = 0.645 and r ISS/NACA = 0.592). The further differentiation on the basis of MAIS, ISS and NACA showed that 51 % of the study group should be classified as slightly injured and 83 % of these were discharged in less than 5 days.
  
  
  CONCLUSIONS
  This study shows that the traffic safety classification of "severely injured" people is not sufficient and most severely injured people are not even approximately recorded. We propose that a new continuous link system between police and medical data will be inevitable for future improvements in traffic safety. The use of established trauma scores and a differentiated look at lengths of stay could be an option.
authors.affiliation: Klinik für Unfallchirurgie, Universitätsklinikum RWTH Aachen. rsellei@ukaachen.de
authors.forename: R M
authors.initials: RM
authors.lastname: Sellei
authors.forename: C
authors.initials: C
authors.lastname: Lank
authors.forename: T
authors.initials: T
authors.lastname: Becher
authors.forename: M
authors.initials: M
authors.lastname: Knobe
authors.forename: M
authors.initials: M
authors.lastname: Rüger
authors.forename: C K G
authors.initials: CK
authors.lastname: Spies
authors.forename: T
authors.initials: T
authors.lastname: Schmitt
authors.forename: J
authors.initials: J
authors.lastname: Peters
authors.forename: H J
authors.initials: HJ
authors.lastname: Erli
mesh_terms: D000063:Accidents, Traffic / Q000145:classification* / Q000401:mortality / Q000517:prevention & control*; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D003299:Cooperative Behavior; D003430:Cross-Sectional Studies; D004282:Documentation / Q000379:methods*; D004779:Environment Design; D005260:Female; D005858:Germany; D006784:Hospitals, Teaching / Q000706:statistics & numerical data; D006785:Hospitals, University / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D033183:Interdisciplinary Communication; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D009104:Multiple Trauma / Q000145:classification* / Q000175:diagnosis* / Q000401:mortality / Q000517:prevention & control; D010343:Patient Admission / Q000706:statistics & numerical data; D016495:Police; D012189:Retrospective Studies; D012737:Sex Factors; D013223:Statistics as Topic; D016019:Survival Analysis; D015599:Trauma Severity Indices; D014947:Wounds and Injuries / Q000145:classification* / Q000401:mortality / Q000517:prevention & control*; D055815:Young Adult